NPI | 1407246812 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95004961) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95044859) |
363LF0000X Nurse Practitioner, Family (Licence: CA 95004961) | |
Enumeration Date | 2015-01-23 |
Last Update Date | 2016-10-10 |